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Full text of "Navy & Marine Corps Medical News 00-06"

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Navy & Marine Corps Medical News 

MN-00-06 
Feb 11, 2000 

The Navy Bureau of Medicine and Surgery distributes Navy 
and Marine Corps Medical News (MEDNEWS) to Sailors and 
Marines, their families, civilian employees and retired Navy 
and Marine Corps families . 

MEDNEWS is a weekly compendium of news and information 
contributed by commands throughout the Navy Medical 
Department. Information contained in MEDNEWS stories is not 
necessarily endorsed by BUMED, nor should it be considered 
official Navy policy. 

To achieve maximum medical information distribution, your 
command is highly encouraged to distribute MEDNEWS to ALL 
HANDS electronically, include MEDNEWS in command newspapers, 
newsletters and radio and TV news programs. 

Stories in MEDNEWS use these abbreviations after a Navy 
medical professional' s name to show affiliation: MC — 
Medical Corps (physician) ; DC - Dental Corps; NC - Nurse 
Corps; MSC - Medical Service Corps (clinicians, researchers 
and administrative managers) . Hospital Corpsmen (HM) and 
Dental Technician (DT) designators are placed in front of 
their names. 

-USN- 

Contents for this week's MEDNEWS: 

Headline: Shelton says DoD must live up to medical promises 
Headline : Bremerton model sets standard for other medical 
facilities 

Headline: Sea service docs provide care to Jordanians 
Headline : Jacksonville trains Midshipmen for Nurse Corps 
Headline: Civilian company assists Great Lakes blood 
collections 

Headline: Mayport dental clinic takes service to the 
deckplates 

Headline: Anthrax question and answer 
Headline: TRICARE question and answer 

Headline: Healthwatch: New healing therapies challenge 
medical boundaries 

-USN- 

Headline: Shelton says DoD must live up to medical promises 
By Jim Garamone, American Forces Press Service 

WASHINGTON — Calling the military medical system "not 
user— friendly, " the Chairman of the Joint Chiefs of Staff 
said TRICARE "must be fixed and the over— all health— care 



system must be improved. " 

Army Gen. Henry H. Shelton told the members of the Senate 
Armed Services Committee Feb. 8 that he thinks America has 
broken its commitment to military retirees to provide health 
care. 

TRICARE is one of the quality of life initiatives DoD 
will stress in the fiscal 2001 Defense budget request. 
Defense Secretary William S. Cohen and Shelton will work 
together in the coming year to change TRICARE. 

"While service members and their families are normally 
very pleased with the care that they receive once they enter 
into the system . . . they are very frustrated with TRICARE as 
a system, " Shelton said. "It is quite frankly immensely 
complex, administratively confusing and not very customer- 
friendly. Our service members and their families deserve 
better. " 

The fiscal 2001 DoD budget request makes some changes. 
In TRICARE Prime, the request eliminates co-pays for active 
duty service members who must get treatment in civilian 
facilities. The request also eliminates the co-pay for 
family members enrolled in TRICARE Prime Remote. 

Shelton said in an earlier speech that DoD must fully 
fund and place more emphasis on the Defense Health Program. 
He also has said the medical plan deserves the attention of 
command at all levels. 

Taking care of military retirees ' health needs is also a 
priority for Cohen and Shelton. "I think that the first 
thing that we need to do is make sure that we acknowledge 
our commitment to the retirees for their years of service 
and for what we basically committed to at the time they were 
recruited into the armed forces, " Shelton told the Senate 
committee . 

He told the senators that DoD has recruiting posters that 
vividly state that not only would the services provide 
medical care upon retirement, "but that their families would 
be taken care of, " Shelton said. "In their minds, we have 
broken that commitment . And I think we have . " 

He said the Joint Chiefs are proposing a plan that would 
provide some type of national pharmacy benefit with no 
enrollment fees for Medicare-eligible retirees . He said the 
chiefs are also examining a MediGap type of insurance for 
retirees 65 and older. "Both these are rather expensive 
programs, but we've got to somehow find a way to start 
providing more than we have in the past, " Shelton said. 

Defense officials agree that the programs will be 
expensive. DoD Comptroller William Lynn said during a 
Pentagon news conference that the cost could be from $2 
billion to $8 billion more per year depending on what 
program is adopted. 

"At the end of the day fixing TRICARE is not only the 
right thing to do, it is the smart thing to do, " Shelton 
said. "It sends a very strong signal, not only to those 
serving today, but all those that are considering a career 
in our armed forces as well. 



"And it keeps faith and keeps the commitment to those 
that have served and retired. We need to get it right, and I 
know that together, we will . " 

-USN- 

Headline: Bremerton model sets standard for other medical 
facilities 

By Judith A. Robertson, Naval Hospital Bremerton 

Editor' s Note: The Military Health System Optimization 
plan supports the development of a comprehensive and 
integrated health services delivery system for MTFs. 

Full implementation of the comprehensive optimization 
plan will result in a high quality, cost effective health 
service delivery system that will be understood by all its 
users and withstand the scrutiny of critics and cost 
analysts. The desire is for the MTFs to be the benchmark 
health service delivery system in peace and war and the 
health services delivery option of choice for our 
beneficiaries . 

Naval Hospital Bremerton is one of several Navy MTFs 
accomplishing the goal of optimizing service to its 
beneficiaries . For more information visit the Military 
Health System Optimization Team website at 
http: //www. tricare . osd.mil/mhsoptplan/default . htm 

BREMERTON, Wash. — Combining compassion, professionalism 
and smart business practices paid off for Naval Hospital 
Bremerton. Its "Bremerton Model" has been selected for 
study by a Washington D.C. joint services team as an example 
of how all other Department of Defense Military Treatment 
Facilities throughout the world should be run. 

The Military Health System's Reengineering Coordination 
Team (RCT) arrived at the Naval Hospital Jan. 11. The RCT 
group, from the TRICARE Management Activity in Washington, 
D.C, toured the facility, listened to those on the front- 
line of providing military healthcare in both the readiness 
and benefit mission arenas, and they also heard a briefing 
on the "Bremerton Model . " 

The RCT came to Bremerton armed with their Military 
Health System Optimization Plan. The 29-page document 
states that full in^lementation of the plan will result in 
military medicine that "will be the benchmark health service 
delivery system in peace and war and the health services 
delivery option of choice for our beneficiaries . " The plan 
is being designed to be a guide for the reengineering of 
military medicine, but when the group saw the Bremerton 
Model, they realized much of what they were conceptualizing 
was already well under way at Naval Hospital Bremerton. 

More than two years ago, under the guidance of hospital 
Commanding Officer Capt . Gregg Parker, MC, Naval Hospital 
Bremerton began a push to align their vision with better 
business practices . The vision states that Naval Hospital 
Bremerton will be the "preferred source for timely, 
respectful and compassionate care with the best possible 



outcomes . " The business practices include boosting 
enrollment, enhancing access to care and improving customer 
satisfaction while implementing cost avoidance measures. 

If imitation is the greatest form of flattery, then Naval 
Hospital Bremerton has received an immense compliment . 

During a briefing in Ross Auditorium, Capt . Mitch 
Heroman, MC, Chief of Staff for the TRICARE Management 
Activity, spoke to a standing-room only crowd of healthcare 
providers and support personnel . 

"We are not here to 'fix' Bremerton, " Heroman said. "You 
are the last place in the universe that needs fixing. " 

Referring to the MHS Optimization Plan the team arrived 
with, Heroman said, "This is a conceptual plan. We are 
incredibly impressed with your Strategic Plan and how you 
are implementing that plan. We have seen your model and we 
are impressed. We are here to ask your assistance in 
developing a plan to reengineer military medicine . " 

Along with Heroman, the RCT comprised Capt . Don Arthur, 
MC, Chief of the Medical Corps and Assistant, Chief for 
Healthcare Operations, Bureau of Medicine and Surgery, 
Washington, D.C.; Col. Ray Burton, MS, USA, Office of the 
Army Surgeon General; Col. Dan Blum, MS, USA, Office of the 
Assistant Secretary of Defense for Health Affairs and two 
members of First Consulting Group, from Lexington, Mass. 

First Consulting Group has been chosen to develop 
implementation strategies and processes for the Military 
Health Systems Optimization Plan. To that end, their 
consultants will be located at Naval Hospital Bremerton, 
working with the staff to meld the Bremerton Model with MHS 
Optimization Plan. 

The Program Objective Memorandum, outlining the entire 
plan, is due for sulxnission to the Department of Defense in 
April . 

-USN- 

Headline: Sea service docs provide care to Jordanians 

By Staff Sgt . Kathleen T. Rhem, USA, American Forces Press 

Service 

WASHINGTON — Navy doctors and corpsmen used their skills 
and gained valuable experience during a recent exercise by 
providing basic medical care to about 600 civilians in 
several Jordanian villages. 

The 23 sailors participated in a medical civil assistance 
program/dental civil assistance program MedCAP /DenCAP , which 
ended Feb. 2. The program was a partnership with Royal 
Jordanian Medical Services to provide care to rural 
villagers, said Marine Capt. Mark Oswell, a spokesman for 
the 22nd Marine Expeditionary Unit, which took part in the 
exercise . 

Members of Navy Fleet Surgical Team Two, assigned to 
Naval Amphibious Base Little Creek, Va. , and crew members of 
the USS Bataan (LHD 5) , currently on a six— month deployment 
in the Persian Gulf, also participated. 



The Jordanians provided additional medical personnel and 
translators . The medics were accompanied by a Marine 
security detail as well . 

"This allowed our doctors, dentists, medical personnel 
and corpsmen to work alongside theirs, " Oswell said. 
"They visited out— of— the— way areas where medical and dental 
assistance isn't readily accessible and taught each other in 
basic screening and basic education classes." 

"We were seeing all comers, from school— age kids to 
people in their 90s. One woman said she was 120, " said 
Navy Dr. (Lt.) Dain Wahl, assigned to the 22nd MEU. "These 
people see a doctor once a year at best . It gives us all a 
different look at medicine." He said the group screened 
villagers in local school buildings and saw mostly common 
ailments and not a lot of surprises. 

"We saw a lot of glaucoma, cataracts and arthritis . 
These are typical ailments for Americans, but we can treat 
them, " Wahl said in a telephone interview. "Here they 
can't, and we saw chronic health problems caused by these 
diseases that we normally do not see in the United States." 

He also said the team saw a lot of children with asthma 
caused by smoking, something else not that common in the 
United States. 

Another Navy doctor from the 22nd MEU, Lt . Doug Bunting, 
said the team was well prepared for the tasks at hand thanks 
to prior coordination with the Jordanian doctors. 

"We brought very basic equipment and x-ray 
capabilities, " he said. "We also had a large supply of 
medicines. We worked with the Jordanians to see what is 
commonly used over here. 

"There are a couple medicines we wish we had more of. 
The Tylenol and ibuprofen we went through pretty quick, " he 
said. 

Bunting explained that even common over— the— counter 
medications are hard for the Jordanians to come by. "These 
villages are mostly concrete apartment buildings with maybe 
one store and no pharmacy, " he said. 

The team was also equipped with a dsntal truck, allowing 
them to provide basic dental services such as filling 
cavities and pulling teeth. 

Jim Garamone, American Forces Press Service, assisted in 
this report . 

-USN- 

Headline: Jacksonville trains Midshipmen for Nurse Corps 
By Lt. Sharon E. Mawby, NC, Naval Hospital Jacksonville 

JACKSONVILLE, Fla. — Naval Academy midshipmen who have 
chosen to serve their country nursing rather than sailing on 
ships are finding Naval Hospital Jacksonville well-suited 
for developing their specialty skills. 

Each year, groups of midshipmen receive training for four 
weeks at the hospital. Each group of two to six midshipmen 
experience a comprehensive clinical rotation through each of 
the inpatient and ambulatory care areas. 



For many midshipmen this is their first hands-on 
experience in nursing under the guidance of a Navy Nurse 
Corps officer. Their training will also include practicing 
what they have learned in the classroom about military 
customs, courtesies, and traditions. 

During their training the midshipmen also tour 
neighboring squadrons, ships and the Trident submarine base, 
where they can see who Navy Medicine's customers are. 

What makes Naval Hospital Jacksonville ideal for nursing 
training is its location that requires medical personnel to 
support numerous ships. As one of the midshipmen stated in 
her journal, "In one hour I learned more than I had in an 
entire month at school . " 

Another midshipman said, "The nurse I was assigned with 
was extremely helpful, patient, and a great mentor. This 
was one of the most beneficial experiences I've had. " 

According to the Chief of Naval Education and Training 
(CNET) , these positive learning experiences have placed 
Naval Hospital Jacksonville as one of the top three 
preferred sites for midshipmen active duty training. 

-USN- 

Headline: Civilian company helps Great Lakes special blood 
needs 

From Naval Hospital Great Lakes 

GREAT LAKES, 111. — The ongoing partnership between the 
Navy Blood Program at Naval Hospital Great Lakes, 111., and 
LifeSource Blood Services is another example of Navy 
Medicine' s business practices enhancing medical care to the 
Fleet . 

As detailed in a working agreement, LifeSource, Inc. , 
collects blood on board the Naval Training Center, and in 
return the company provides free special blood products to 
active duty Navy personnel and their family members during 
medical emergencies. 

Lt . Roland Fahie, MSC, director of the Navy Blood Program 
for the Mid-West, said the agreement between the hospital 
and the civilian company saves the Navy money, ensures a 
source for rare blood types, and it is a source of blood 
platelets . 

Fahie said that without the agreement with LifeSource, 
the hospital would have to go shopping for rare blood 
products, and that could be very expensive. But just as 
important, the hospital could find itself short of blood 
platelets, a valuable clotting agent for those whose blood 
won't clot. 

Blood platelets only last a few days and have to be 
constantly restored," said Fahie. "The agreement with 
LifeSource provides a constant platelet source without us 
having to develop a facility to do that . " 

The benefits of the working agreement with the company 
are not just advantageous to the Navy. 

William Portman, president of LifeSource said that [the 
training center] is an integral part of [Chicago' s] blood 



supply. He said one of the ways Sailors demonstrate their 
caring for human beings is by donating blood. 

Great Lakes blood drives are administered by the naval 
hospital 's Blood Donor Center, which, in addition to 
providing LifeSource with blood, provides blood to the naval 
hospital, the National Naval Medical Center in Bethesda and 
other Department of Defense medical treatment facilities. 

Naval Hospital Great Lakes provided blood in support of 
operations in Kosovo and in response to the terrorist attack 
on the US Embassies in Kenya and Tanzaniya, Africa. 

-USN- 

Headline: Mayport dental clinic takes service to the 
deckplates 

By Earl W. Hicks, Bureau of Medicine and Surgery 

MAYPORT, Fla. — The Mayport Dental Clinic Annex has 
refined dental care at the deckplates with mobile service 
and convenient locations for Sailors needing help with a 
cavity or getting their teeth cleaned. 

After fifteen months of labor, Seabee construction 
battalions completed the Mayport Dental Clinic Annex in 
September 1999. The facility, built especially to provide 
pier side dental support for Fleet personnel, is only about 
100 yards from the ships. 

Today, the 4, 000 square foot facility, which houses 10 
dental treatment areas, oversees dental screening support 
and patient education for more than 8, 000 shipboard Sailors 
on the waterfront . 

Highlighting accessibility of the facility to Mayport 
ships, annex director, Capt . Roger Wray, DC, said, "You can 
throw a baseball from the doorway and hit a ship. " 

And there is plenty of help waiting for those who enter 
that doorway needing dental care. Four dentists, dental 
hygienists and dental technicians are waiting to see 
patients Monday through Thursday from 7 a.m. to 4:30 p.m. 
The annex is expected to have more than 10, 000 dental visits 
each year. 

But Wray' s dental team wasn't satisfied that they had 
done all they could do to provide expeditious service to the 
ships' crews. In addition to the annex's close location, 
Wray added a mobile van service similar to those used at 
dental facilities in San Diego and Norfolk. 

Three vans, each having two examination chairs and an x— 
ray unit, can locate close-in to a ship and conduct 
examinations, do cleanings and fillings . 

"We do about 40 dental exams a day in the vans, " said 
Dental Technician Second Class Carlson Bryan from New York, 
N. Y. "I work with the ship' s corpsman to schedule 
appointments, and we either provide treatment that same day 
or come back when it's more convenient for the ships' crew. 

"In some cases a patient will have to get treatment at 
the annex or the base dental clinic. But they don't have to 
walk to the clinic for work we can do in the vans." 

With the convenient location of the annex and the 



mobility of the vans, ships headed for Mayport will not have 
to want for most dental care. 

"We are not here just for Mayport home— ported ships, " 
said Wray. "An example of the other ships we support is 
the San Diego-based USS Curts (FFG 38) . When it was here, 
we treated approximately 50 of its crew. " 

Appreciation for ease of access to care has been voiced 
by junior enlisted and ship's commanding officers who have 
used either the annex or the vans, said Wray. 

"We do whatever we can to expedite dental service to the 
ships, " he said. "We want to save them time and 
contribute to their readiness." 

-USN- 

Headline: Anthrax question and answer 
From Bureau of Medicine and Surgery 

Question: Who is at greater risk from a biological 

attack? Soldiers? Sailors? Airmen? Marines? Front line? Rear 

area? Logistical units? 

Answer: Anthrax weapons have the potential to cover wide 
areas of a battlefield. It is difficult to determine who 
would be at a greater risk from a biological threat . The 
entire force needs to be protected. For more anthrax 
information, visit the Navy anthrax website at http:www— 
nehc.med.navy.mil/prevmed/immun/anthrax.htm or the DOD 
anthrax website at http://www.anthrax.osd.mil 

-USN- 

Headline: TRICARE question and answer 
From Bureau of Medicine and Surgery 

Question: Are there any deadlines or restrictions for 
enrolling in TRICARE Prime? 

Answer: If implemented in your area, you may enroll in 
TRICARE Prime at any time. Please note that while 
enrollment for Prime is on a continuous basis, assignment to 
a Primary Care Manager in a military clinic, where treatment 
is free, is based on availability. 

For more TRICARE information visit the website at 
www. tricare.osd.mil 

-USN- 

Headline: Healthwatch: New healing therapies challenge 
medical boundaries 

By Earl W. Hicks, Bureau of Medicine and Surgery 

WASHIINGTON — Getting your energy field changed or 
petting a dog may contribute to your healing process as 
today's Navy Medicine explores complimentary therapies for 
its Military Treatment Facilities. 

The medical qualifier for these new therapies is that 
they do the patient no harm and they make the patient feel 
better. 

These new healing techniques are among complimentary 
medicine methods, such as acupuncture, herbs, aromas, music 



and guided imagery being tested in some Navy medical 
facilities . 

Cmdr. Nancy Silki, NC, has experienced success with the 
"Healing Touch" therapy at Naval Hospital Twentynine 
Palms, Calif., and now at Naval Hospital Pensacola, Fla. 

"Healing touch is an approach to helping individuals by 
restoring balance in the human energy field, " she said. 
"It is generally believed that when there is a disturbance 
in the human energy system, an illness occurs." 

Silki said the healing touch experience is non-invasive , 
economical and effective . There is no manipulation, poking 
or prodding. The therapy promotes patient wholeness and 
wellness, and it increases the efficacy of medication. 

Silki emphasizes that healing touch is used as an adjunct 
to other therapies, not in place of them. 

"I like to help my clients in the healing process by 
using various assessment techniques and intentionally 
directing the flow of energy to allow the body to heal 
itself, " she said. 

And the new therapies, although not available everywhere, 
are being practiced at several Navy MTFs. Pregnant women 
use healing touch at Naval Hospital Bremerton, Naval 
Hospital Camp Lejeune recommends using herbal therapy for 
colds. Naval Hospital Jacksonville uses music, biofeedback 
and guided imagery for pain reduction . Because the programs 
are in their preliminary evaluation stages, they are not 
available in all areas. 

In most cases the therapies are still under evaluation by 
either formal research methods or command executive review 
to determine how they augment traditional medicine and what 
influence they have on clinical outcomes . 

But while the evaluations are ongoing, care providers 
such as Silki believe they do make a difference. 

"I 'm very interested in alternative ways to care for our 
patients, " she said. "Many healthcare professionals feel 
helpless when traditional medicine does not seem to be 
working to relieve chronic pain or stress. New therapies 
such as the healing touch may provide yet another way to 
ease that pain . " 

-C7SN- 

Comments about and ideas for MEDNEWS are welcome . Story 
submissions are encouraged. Contact MEDNEWS editor. Earl W. 
Hicks, at email: mednews@us.med.navy.mil; Telephone 202/762— 
3223, (DSN) 162-3223, or fax 202/762-3224. 

-USN- 

-USN-